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Indigenous men diagnosed with more advanced prostate cancer

Canadian study finds Indigenous men are at higher risk of developing aggressive prostate cancer
33263855_web1_230710-CPW-Indigenous-prostate-cancer-doc_1
A doctor wears a stethoscope around his neck as he tends to patients in his office in Illinois, Tuesday, Oct. 30, 2012. Indigenous men have more serious and later-stage prostate cancer when they害羞草研究所檙e diagnosed than non-Indigenous men, a new Canadian study says. THE CANADIAN PRESS/AP-Jeff Roberson

Indigenous men have more serious and later-stage prostate cancer when they害羞草研究所檙e diagnosed than non-Indigenous men, a new Canadian study says.

害羞草研究所淚t is very clear from this data that Indigenous men are at higher risk of developing aggressive prostate cancer than non-Indigenous men,害羞草研究所 said Dr. Adam Kinnaird, senior author of the study and the Frank and Carla Sojonky Chair in Prostate Cancer Research at the University of Alberta.

The study, published Monday in the journal Cancer, looked at prostate cancer screening data among almost 1.5 million men in Alberta between 2014 and 2022. They were all between 50 and 70 years old.

Using postal codes, the researchers found that men in First Nations and M茅tis communities were much less likely to have had a prostate-specific antigen (PSA) test 害羞草研究所 the method used to screen for prostate cancer 害羞草研究所 than men living outside of Indigenous communities.

害羞草研究所淣on-Indigenous men are having their PSA test done 50 per cent more often than Indigenous men are. And that害羞草研究所檚 a pretty big difference,害羞草研究所 Kinnaird said.

The lack of screening, he said, could be a contributing factor to the study害羞草研究所檚 other major finding 害羞草研究所 that at the time of diagnosis, prostate cancer in Indigenous men was more advanced and more aggressive than in non-Indigenous men.

That finding was based on the tumour characteristics of 6,049 men diagnosed with prostate cancer who were seen at urology referral centres at the University of Alberta in Edmonton and at the University of Calgary.

Dr. Jason Pennington, a surgeon at the Scarborough Health Network and the Indigenous lead for the Central East Regional Cancer Program in Ontario, said the results are 害羞草研究所渘ot surprising.害羞草研究所

害羞草研究所(They are) actually supporting findings that we害羞草研究所檝e been getting from Ontario,害羞草研究所 said Pennington, who was not involved in the study and is a member of the Huron-Wendat Nation.

害羞草研究所淭his is what we see across Canada and across Indigenous populations around the world.害羞草研究所

One weakness of the study, Kinnaird said, is that because it relied on postal codes, it couldn害羞草研究所檛 compare the rate of PSA testing between Indigenous and non-Indigenous men living in cities.

About half of the Indigenous population lives in cities, he said, and researchers will be looking at data in another Alberta study to try to find testing rates for urban Indigenous men.

Kinnaird害羞草研究所檚 team also plans additional research to determine whether or not there might be a genetic factor that could make Indigenous men more prone to aggressive prostate cancer, he said.

That害羞草研究所檚 something that occurs in the Ashkenazi Jewish population, he said.

The study did not look at whether or not prostate cancer was more or less prevalent overall among Indigenous men 害羞草研究所 just at screening rates and severity at diagnosis.

There are many possible reasons Indigenous men are both tested less and suffer more advanced prostate cancer, Pennington said.

Lack of access to a primary-care provider to get screened is a likely factor, he said, along with social determinants of health, such as poverty, which could make it difficult for someone to take time off work to get a PSA test.

Kinnaird said it害羞草研究所檚 critical that health-care providers are aware of the inequity of prostate cancer screening.

害羞草研究所淚t害羞草研究所檚 something that害羞草研究所檚 important for Indigenous men, for family physicians, for nurse practitioners and for urologists to bear in mind that when you are seeing an Indigenous man in your clinic that you are really thinking about whether you need to screen for prostate cancer,害羞草研究所 he said.

Indigenous distrust of the health-care system is another potential factor behind lower screening rates, Pennington said.

害羞草研究所淓very Indigenous person I know, every Indigenous family I know, has had negative experiences in our health-care system,害羞草研究所 he said.

One promising solution is holding community screening days, Pennington said, where Indigenous 害羞草研究所減atient navigators害羞草研究所 and Indigenous nursing staff are present to answer questions and provide a culturally safe environment. Families can go together to help them feel more comfortable, he said.

That approach also works in remote Indigenous communities with mobile screening buses, he said.

Pennington said the time has come to implement more of these types of culturally safe Indigenous strategies and measure their success.

害羞草研究所淲e害羞草研究所檙e starting to have quite a bit of evidence now regarding the lower screening, the higher stages (of cancer), the poor outcomes,害羞草研究所 he said.

害羞草研究所淚t害羞草研究所檚 about time we start doing something about it.害羞草研究所

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